Travel to and from Kampala: Matatus and the new taxi park

Living in rural Uganda, has meant several trips to Kamapala (the big city), in order to experience some semblance of anonymity and generally, have a break from life in Kasana.  We have found an inexpensive, friendly, clean hostel where you can do work and experience consistently full internet bars which is unheard of in our rural home.  For 11,000Ush (approximately $5), getting to Kampala is relatively easy by public transport – meaning matatu minibuses, which congregate near the fruit vendors on the Kampala-Gulu highway (the only paved road) which runs through the centre of Kasana.  While only 70-ish km to Kampala, the trip by matatu, can take anywhere from 1.5 – 3 hours depending on the traffic congestion within Kampala, and the amount of time required to wait for the matatu to leave.

To maximize trips, the matatu vans only leave when they are full, which is “14 passengers” according to the painted writing on the matatu door.  Typically however, this number is far exceeded.  The vans themselves, are essentially modified cargo vans (with windows),  with 5 rows of seats installed, none offering functional seatbelts.  The seats along the passenger side flip down to allow access to the rear of the van, and are often more wobbly than the others (which are bolted to the base of the van with varying degrees of security).  As the second most common mode of transportation in Uganda (next to the boda boda motorcycles), matatu vans are “somehow” safe means of transit and everyone has their own philosophy as to the best place to sit while in transit.  Many swear that it is best to sit at the rear, as the vehicles are often involved in head on collisions, thereby categorizing the first 3 rows as “crumple zone.”  That being said, it the van rolls into a ditch, good luck getting out of the back due to bars which extend the medial length of the matatu’s rear windows.  Following more than one successful journey, my traveling companions and I have shared our thoughts as to our mental contingency plans should the vehicle not make it to our expected destination – it is best not to verbalize these thoughts during the trip itself.  After reading about matatus’ dubious safety record, my mother called me from Canada to tell me I should be wearing my bicycle helmet while in transit… as if a mzungu (white person) doesn’t already stand out enough, not to mention the lack of head space requireed to accommodate the helmet (sorry mom, I know your thoughts were well intentioned, but they primarily provided us with comic relief). 

Matatu vans leaving Kasana travel to the New Taxi Park in Kampala.  The taxi park is an indescribable sight which must be experienced firsthand.  It is the size of a football field jammed with thousands of identical white matatus, lined bumper to bumper in what appears to be “organized chaos”.  Each corner of the unpaved park contains a red sign indicating the region of Uganda to which the vans will travel.  Much time can be spent negotiating through the park in order to find the right destination area, during which time, one is continuously dodging moving vans, vendors, mud puddles, other travelers and swindlers.  If you are likely to be mugged, this is the area in which it will happen due to the congestion, and the ability for thieves to easily disappear among the crowds and vans.

The park also acts as a makeshift garage, with all types of vehicle repairs ongoing amid the chaos.  The other day, myself and my traveling companion climbed into a van heading to Luwero (the district in which Kasana is located).  We were excited because the van was nearly full, meaning we would be leaving soon.  However, after waiting 15 minutes we were still not on our way, and we began to look around.  It was at this point that I noticed there was no driver’s seat – at all, merely a rusting white painted metal void where a seat usually rests.  Turning to the man to my right, I pointed and asked about the driver’s seat, the man casually pointed upward.  My friend and I decided to change vans after waiting another 10 minutes with still no action, or anyone looking into installing a seat. 

After switching vehicles, we could see our former matatu.  Sure enough, the driver’s seat was propped up on the roof, with all the other passengers still patiently waiting for something, or anything to happen.  Half an hour later, as we drove out of the park, nothing had changed.  All the passengers still waiting, and the driver’s seat remained uninstalled on the vehicle’s roof.  I began to wonder if maybe there was a reason all these people were waiting for that specific van to leave – perhaps the driver is especially safe and worth waiting for?

               While you’re waiting for a matatu to leave, you need not worry about entertaining yourself, or getting peckish.  Hundreds of pushy venders swarm filling vehicles, offering anything and everything for sale.  Through the van’s open doors and windows, men and women try to sell their goods often handing or throwing items at you with the expectation that you will buy.  The perception also exists that mzungus have money to spend, and therefore should be buying regardless of need.  At any given moment at least 1 vender will be “working your van” while you wait to depart the park.  Once, I nearly lost a lock of hair from my ponytail.  I was turned around speaking with someone seated behind me, and a buzzing noise in my ear made me whip my head around only to find a man selling electric razors, with one turned on inches from my face.  My startled look prompted a roar of laughter from the vendor and adjacent passengers.  While some become aggravated or annoyed by the sellers, I find it quite entertaining, and an opportunity to joke around.  “What are you saying?”  I ask in fictitious horror, to a man pushing deodorant sticks toward my face, while dramatically inhaling the scent from my armpit. “I already smell like roses” I insist, to the contrary, wondering if the guy actually did have something on me.

I also find it interesting to see all the different items being sold.  Nonetheless, I have discovered that the Lugandan word “Sagala” which means “I do not want,” is invaluable when dealing with the taxi park vendors.  It is the theme of the following “Dr. Seuss” inspired poem I jokingly wrote while waiting for the matatu to leave during my last trip home from Kampala.  

Sagala – I do not want

(Dr. Seuss meets Kampala's New Taxi Park)

I do not want it in the van,

I do not want it from that man.

I do not want it through the door,

I do not want it on the floor.

I do not want if off your head,

I do not want it green or red.

I do not want it from a box,

I do not want that pair of sox.

I do not want samosa pie,

I do not want a man’s shirt tie.

I do not want a loaf of bread,

I do not want a spool of thread.

I do not want cassava chips,

I do not want them, read my lips.

I do not want a soda pop,

I do not want a brand new mop.
I do not want a fried hopper,

Clearly, I am not a shopper.

I do not want a leather belt,

I do not want an ice cream melt.

I do not want a solar light,

I do not want it black or white.

I do not want a tray of fruit,

I don’t want any of your loot.


I do not want those eyeglass shades,
I do not want those shaving blades.
I do not want those children's books,
I do not want your pleading looks.
I do not want a wooden mirror,
"Sagala sir," I think that's clear.

I do not want that perfume spray,

I do not want it from a tray.

I do not want a cooking pot,

I do not want food cold or hot.

I do not want a bar of soap,

I’m sorry that I crushed your hope.

I do not want a bag of nuts,

I do not want your jackfruit cuts.

I do not want a stick of gum,

I do not want them for my mom.

I do not want hair for a weave,

How much longer untill we leave?

I do not want mosquito nets,

I do not want your bracelet sets.

I do not want those biscuit cakes,

I do not want your knock-off fakes.

I do not want that cell phone time,

I do not want it, that’s the rhyme.

Now here comes passenger 19,

That’s not the most I’ve ever seen.

So finally we are set to go,

And leave these venders to their show.

Still one more time leaving the park,

“Sagala” is my last remark.

Source - http://outofuganda.wordpress.com/2008/06/
Pulling out a camera is not advisable due to concerns about theft. 

Quality medical care in rural Uganda: Frustrations and access

                The hospital property began approximately 50 meters beyond the paved main road.  It was composed of several single story buildings arranged in an L shape.  A round structure was being constructed in the centre area and several men were working in the sun with hand tools, digging in the red clay soil.  Without any visible signs indicating the appropriate direction for reception I walked through the complex.  First, passed the restaurant, then the gift shop, and eventually on to a section with a sign above the door saying “lab”.  To the right, was a final door with “children” hand written on a block of green painted wood.  Through the open door I could see children in cribs lined up against the distant wall.  I decided I had walked too far, and began to back track past the construction area. 

I came upon a wooden bench poised under an open yet barred window, with two men sitting in the afternoon sun.  One man appeared much older with thin grey hair. 

“How can I speak with a doctor?” I asked of the men.

The younger man pointed to the open door to the left of the bench.  Gathering this was the reception and waiting room, I took a seat, looking up at the small roof extension providing little shade.  I wondered where people wait during the nearly daily torrential downpours of rain. 

                Then it began, again - the children’s curiosity / infatuation with white skinned people.  One observant young child had noticed me, and sent out the call, alerting all children in the nearby area.  “Mzungu! Mzungu!” (translated to white person).  

Suddenly, a group of 8 – 10 children appeared, running at full speed, swarming me and yelling “Mzungu!  Mzungu!”  While typically not bothersome, I was not in the mood to deal with hoards of screaming children who wanted to touch and poke at my white skin, or receive high-5’s.  I had gone to the hospital because I felt ill. 

The Mzungu commotion extended down to the paved road, attracting a young man who wandered over, shooing the children away.  While immediately grateful, I quickly realized the man had ulterior motives. 

“How can I be your friend?  What is your phone number?  I would like to call you.”  He began. 

“Seriously?” I thought, “This man doesn’t even know my name.  People come to hospitals to get better when they feel ill, not pick up their next fling!”.

                At that moment a young woman left the “doctor’s office” and the younger man rose from the bench, helping what I now understood to be his elderly father.  As the old man rose, the bench tipped sideways like a teeter-totter and I barely caught myself from slipping to the ground.  My new “friend” took this as an invitation to join me on the bench.

“Ah!” he exclaimed, then repeated “I cannot be your friend without your phone number.” 

“I’m sorry, I don’t give out my phone number – it is the orders of the organization I am working with.  It is their phone.  Besides I am married” I lied. 

“Ah!” he repeated, “but you wear not ring” he replied flashing a cheeky grin.  Clearly there was no fooling this perceptive young man.  In the moments that followed we made small talk.  He asked where I was from, what tribe I represent, what I was doing in Uganda, where I live in Kasana (nice try)…

                After what felt like forever, the elderly man shuffled out of the doctor’s office with the young man supporting his arm.  In Canada this man would likely be using a wheelchair or a walker at the very least, but with uneven clay mud roads, and boda-bodas (motorcycle taxis) as means of transportation, both options seemed impractical.  I stood up, to walk into the office, saying “bye” to my new friend who assured me he would wait for me.

                The office was small with a blue vinyl examination table sitting under the open uncovered window (separating the examination room and waiting bench) and wooden desk in the centre.  I walked over to the blue plastic chair adjacent to the doctor’s table and took a seat.  Getting right down to business the man asked

“How can I help you?” 

I explained that I had a very sore throat with white patches on my tonsils, and a fever. 

“I will test you for malaria” said the man, making illegible notes on a piece of paper.  “The malaria test may be negative because the parasite stays in your liver first, before replicating enough to be detected in the blood which we test.” 

I nodded in agreement, and tried to re-direct the conversation back to my throat (not a symptom of malaria).

                “Take this to the lab” directed the doctor.  “You will be tested for malaria.” 

                “The lab is that direction?” I clarified, pointing to the direction I had previously passed.

                From outside the door my new friend called out “I know where the lab is, I can show you.”  Clearly I was experiencing public not private health care.

                Walking toward the lab, my friend once again requested my phone number, this time in order to monitor my speedy recovery.  I thanked him for the well wishes, but insisted I would not be disclosing my telephone number.  Now, outside the laboratory door, he wished me well and left. 

                The laboratory was nestled between two sequential buildings, and adjacent to the pharmacy.  The open door revealed a young woman sitting in a chair, supporting her downturned forehead with her right palm while her left arm was inspected by a man I presumed to be the lab technician.  I elected to wait outside, sitting on a bench covered by cool shade cast by the neighbouring examination rooms.

                From around the corner crept two young children, a girl wearing a torn, dirty, pink dress who appeared older, and a shorter boy who presented a more confident demeanor. 

                “Mzungu.” Stated the young boy definitively, touching my arm and confirming that in fact my skin remained white when touched.  I smiled and waved, not wishing to become engaged in a further discussion.  My head felt foggy, and the infection in my throat meant talking and swallowing were incredibly painful.  At that moment, my only wish was to be magically transported back to my bed. 

                Moving on, the children wandered into the laboratory.  Words were exchanged in Lugandan, which I did not understand.  As the young woman stepped out of the laboratory, the woman turned back and muttered something to the children, then disappeared around the corner of the building.

                Walking into the lab, I took a seat, without waiting to be offered.  The lab technician was preoccupied with the children, counting bills and coins from his pocket which he gave to the young boy, followed by clear instructions to “return  a immediately.”  Taking advantage of the distraction the young girl picked up a pair of tweezers from the table, first inspecting them, and then trying to pick up the little blue plastic pieces scattered across the table’s workspace.  I later discovered these pieces protected the needles used to perform malaria tests.

                The room’s temperature was cool.  Along one side were open windows, each covered by decorative security bars but no screens.  A stand up work space under the windows contained a microscope and what appeared to be several slides waiting to be inspected.  An old centrifuge type machine caught the attention of the young boy (who still had not yet left with the lab technician’s money).  He began to spin the moveable parts as if it were a miniature mary-go-round for parasites.

                “Ah!” gestured the lab tech, pointing the children out the door.  Turning his attention to me, he asked for the piece of paper provided by the doctor.  Without saying a word, the man began to open the materials necessary to perform a malaria test, then pausing “Name?” he asked “I must put your name on this test”.

                It was at this moment it donned on me that the doctor I had spoken with did not know anything about me or my medical history, and he still (in my mind) had not addressed the reason for my presence in his office.

                After writing my name on the plastic test piece, he pricked my finger with his un-gloved hands (not washed after handling money and who knows what else) and directed the droplet of blood into the test receptacle.  He added a few drops of liquid, and told me to wait 15 minutes during which time he returned his attention to making microscope slides.  I sat, amazed by the hygiene and protocol for interacting with blood, especially in a country with such a high rate of HIV / AIDS infection.  Legislation in Canada dictates that all food and beverage preparation areas must have a dedicated hand washing sink, and here, I was in a medical laboratory which did not have running water or access to gloves!

                After waiting 15 minutes, the lab tech returned the slip of paper to me, and said I must return to the doctor.  He did not clarify the result of the malaria test, but I assumed it was negative, a result confirmed by the doctor who’s response was “I think you know why the test came back negative.”

                I wanted to say “because I don’t have malaria?” but decided he was instead referring to his earlier explanation of hepatic parasitic replication. 

                Despite the negative malaria test, he decided to write me a prescription for malaria, which made me question why I’d gone to through the motions of having the test done in the first place.  Now concerned about drug interactions, I reached into my backpack and found the only medication I’d been taking while in Uganda

                Presenting the unopened sleeve of pills for the doctor to review, he asked “What is this?”

                I explained that Malarone is an anti-malaria medication like doxycycline (another anti-malaria drug more commonly known here), and provided the man with the thin, folded paper supplied by the drug company to explain the medication.  “I think I will keep this, so I can learn about this drug” he insisted, handing me a prescription, not having even glanced at the Malarone drug details.

                Still convinced I did not have malaria, I mentally decided I would not take his prescription, and therefore did not press for details such as whether it would be advisable to suspend taking Malarone while on his treatment.  I did, however, try again to redirect him back to my throat.  Still uninterested in looking inside my mouth (or inside my ears, or feeling lymph nodes… all doctor-like behaviours I have come to expect in conjunction with complaints of a sore throat), I made him look at a picture of my throat that I’d taken with my iPhone camera.  He told me he would give me something for my throat, and added it to the anti-malaria prescription list, but never did look in my mouth.  He instructed me to fill the prescription next to the laboratory, and to return for a follow-up in 10 days.

                The pharmacy resembled the laboratory.  There was no sink, and pills were counted by hand on a wooden table.  Flies buzzed around, and I tried not to question the hygiene of having a pharmacy with open windows.  During my first week in Uganda, I met a couple who run an NGO that educates families about home hygiene in order to minimize illness and disease.  Part of their mandate involves communicating the importance of covering latrines to prevent flies from transferring pathogens between excrement and food.  Since that time, I haven’t looked at flies the same way, and at the pharmacy I tried to shut out thought questioning where the flies had been given the hospital setting.

                I returned home, wishing I had simply spent the day sleeping in my bed.  I paid 16,000 Ush (less than $8 USD) for four prescriptions, a “consolation” fee, and a lab fee.  While inexpensive by Canadian standards, this service would consume 20 – 25% of a local’s monthly salary, and in the end, I was not convinced I was any better off.  The next day I went into Kampala to a western style medical clinic where I was given a prescription for penicillin to treat strep throat.  The doctor there, (after a thorough examination) assured me that I did not have malaria, and instructed me not to take any of the prescriptions filled the previous day.  The visit and penicillin cost 59,000 Ush (approximately $30 USD), and while still inexpensive by Canadian standards, when combined with the 100,000 Ush ($50 USD) I paid for  return private transport to Kamala, accessing this type of medical service would be out of the question for most Ugandans living in Luwero (this would account for approximately 1.5 month’s salary).

                The consequences of inaccessible, quality, medical care in rural areas are multi-fold.  Mis-diagnosis and over prescription of certain medications leads to ineffective drug treatments and pathogenic mutation.  Lack of proper care, means locals are unable to adequately work and provide for their families to say nothing of their own personal discomfort.  Poor hygiene and lack of access to utilities such as water and electricity exacerbate illnesses and augment the transmission of disease (to say nothing of the health risks associated with a medical facility that does not have access to running water, or means of physical protection – ie. gloves, for staff members).  There are also significant health risks associated with misdiagnosis, and untreated conditions… I could go on.  Though grateful to have had access to the clinic in Kampala, I wish those I work with in Luwero could have the same opportunities.  After all, access to medical care is a human right.

Shanti Uganda: My first few weeks

                My name is Tara.  I am a Recreation Therapy degree student going into my third year of studies at Douglas College.  I am doing my practicum placement in Uganda at a maternity and learning centre called Shanti Uganda.  Shanti is located in the small village of Nsassi (which is in the greater district of Luwero), an hour and a half drive north of Kampala. 

                Beyond being an accessible, holistic, maternity and birthing centre, Shanti offers many other community programs including outreach workshops designed to empower teen girls, a demonstration garden with agricultural workshops, and a craft-style skill development group which enables women living with HIV / AIDS to generate an income by making bags, purses, and jewelry, which Shanti then sells overseas in Canada.  Shanti means peace, and most of their programs offer an emotional / spiritual element in which the women learn and practice yoga.  The property itself is also incredibly peaceful, nestled among large trees, and surrounded by the sounds of chirping birds.

                During my time at Shanti, my two main assignments are to facilitate two sessions of the teen girls empowerment program (while students are out of school on break), and to complete an assessment to determine the needs of teen mothers who have given birth and are no longer attending school.  In the future, Shanti hopes to develop a program designed to help teen mothers in similar situations (and I have discovered there is no shortage of these girls living in our area of Luwero). 

                Thus far, I have experienced many challenges working overseas.  Adjusting to another’s cultural norms takes time, as does the familiarizing oneself with new daily routines.  In Uganda, nothing happens fast.  Meetings which are supposed to start at 1pm, begin at 3pm (if you’re lucky).  Load sharing means that the power is inconsistent and unpredictable, therefore, it is necessary to keep appliances and aids such as computers and cell phones charged as frequently as possible (to date, 72 hours was the longest we have gone without power, which coincided with 5 days of no running water – something not worthy of recounting to locals who view tap water as a luxury).  In town, there is no such thing as a quick trip to the store.  Ugandan culture strongly values social interaction, and walking into a store without first chatting for 10 minutes is deemed to be rude and borderline hostile.  There is also no anonymity being a mzungu (white person) living in a small, rural Ugandan town.  Upon stepping out of the locked compound where we stay, children follow in droves yelling “bye mzungu!” “hi mzumgu!” (often in that order), with the younger ones calling out something which sounds more like “mugugu!”  It is not uncommon to for them to reach out and want to touch your skin – something which can be un-nerving when trying to cycle past them without running over their bare feet.  One neighbourhood child even climbs a jackfruit tree outside out walled compound, and while poised in the tree’s limbs calls out for us “mzungu!” when we are doing laundry on the porch, or trying to do work indoors in the living room.

               Children and animals are everywhere.  Initially I felt like I was living on the set of a World Vision commercial.  In Canada, child welfare would be called if a 2 foot tall child was caught playing with and caring for an infant in the street.  (I describe children according to their height as ages are difficult to determine with many kids being malnourished, while their faces appear much older than they are, perhaps due to the significant responsibilities which are bestowed upon them).  As the days pass, however, I find myself becoming complacent to such scenes, and upon reflection, I am shocked by the fact that I now see unsupervised children in the streets as typical and normal.

               Everywhere, a lack of resources is an ongoing issue.  It is difficult to articulate how little facilities (particularly government run institutions) are able to offer.  As an example, we taught the first session of the Teen Girls program out of a local school room.  The packed dirt floor provided an uneven base for which students could sit on blue and white plastic chairs which the students carried to the room each morning from a locked storage facility located on the other side of the property (there are no desks or tables on which the children can work).  The walls made of clay brick were bare, and offered no chalk boards or even hooks on which one could display visual aids.  Without electricity, light shines in through small open windows which provide little protection to students when torrential rains begin.  This is a typical rural Ugandan classroom, ordinarily accommodating as many as 200 students (each responsible for purchasing their own school materials such as notebooks and pencils).    

                It is easy as a foreigner to come here and forget just how much you have, and the opportunities such privilege affords.  While we take weekend trips to national parks, immersing ourselves in amazing Ugandan scenery, and experiencing African wildlife firsthand, it must be acknowledged that these opportunities are out of reach for most locals.  I fear we are not always sensitive to this fact.  After watching Disney’s the Lion King on computer with a young Ugandan woman, we spoke about the animals so prominently featured in the film.  She had never seen or heard of a warthog, though she excitedly described seeing a lion once in an Entebbe zoo.  To put things in perspective, it would cost her 10 months salary to purchase a 1 day park pass to go gorilla trekking (the price of which is going up by 50% in the near future), and that cost doesn’t include paying for the mandatory guide, transportation, accommodation, or food.  

Children playing with jerry can cars near a local borehole.

Time has flown by...

We are entering our last two weeks in Masaka. I can't believe that I have been here for 2 months already. It has been full of learning.

At the regional hospital, I have been part of support groups, home visits, medication counting and clinician sessions. I have a new appreciation for the challenges for treatment here and have gotten to know many patients. The distance that people travel, the barriers at the hospital... I take for granted all the services that I am able to access for my clients in Vancouver.

At Tekera, we have spent a lot of time with the children in the school. The loveliest experience is when the young children were doing gym outside. They were singing and jumping around. It was so fun to participate with them. They are so full of joy and are thankful for their education. It is such a beautiful place.

As the time is finishing, I will take all the moments from Uganda back home and cherish them. I look at my pictures and can't wait to tell everyone the stories that I have experienced. I will see everyone when I get home.

Lesley

This is going to start sounding a little repetitive, but where has the time gone? It is Sunday afternoon here in Masaka, and after a rainy few days, the sun is shining and the heat is cranked. We have just been discussing that we are heading into our final three weeks, and we are all having mixed feelings about this fact. Since I wrote last, I have learned and experienced so much more than you could imagine. The first few weeks here felt a little “rainbows and lolli-pops” for me, and in a way I have been waiting for that bubble to burst. I cant say it hasn't been wonderful, but I have had a bit of a reality check these past couple weeks. The children all went back to school on the 14^th/21^st of May, so Anaweza has become very quiet. The last project we did with the kids was; The Anaweza Chicken Project..2012! We had the children split into groups of about 5 based on where they live, and each group was given a chicken to look after with the intention of bringing back 2 eggs to Anaweza so the project can continue. The purpose is to not only have the children work together as a group with a specific goal to reach, but also to give something back to their community that can continue on. The sustainability factor is always at the forefront of my mind when thinking of projects to develop. We have not seen much of the kids since then, so this week we are going to do some community visits and check in with the families and their chickens! I have full confidence that the kids are taking good care of Ruth, Beyonce J, Canada, Blessing, and Promise (yes, those are the chickens names...personal fav-Ruth!). So other than that, most of the time spent at Anaweza has me, yes, ME, teaching computers to people in the community that have heard through the grapevine we have a couple of computers there now. It is great to see people of all ages so eager to learn how to type, create documents/spreadsheets, and surf the net. I am still in awe of Julius and his hard work and persistence. He deserves so much credit, but is much to humble to even realize it.

Kitengesa Secondary School and Community Library are where I now spend three days a week. I wish I could have been there from the beginning as there is so much potential and opportunity, but of course school was not in session, so my days would have been pretty lonely. On the library side I have been working alongside 4 UBC interns developing reading and writing programs with the students at both Kitengesa Sec and some of the surrounding primary schools. We either visit the schools and read with/to the students and then dedicate some time to comprehension, or we bring the students back to the library and do the same. I feel like my ego is inflating every time we go to the schools because the primary kids literally see us coming miles away and start screaming and running out of class to greet us. It's a great and weird feeling, but I love to see how excited and attentive they are when we read together. One of the schools we visit is a school for deaf children. Unfortunately I don't have much of an opportunity to go there as much as I would like, because the schedule conflicts with another project. I am so glad the UBC students are making such an effort to visit the children at the deaf school as they have never had international students there before. The deaf school is on the same grounds as one of the primary schools, so I can just imagine they have seen people come and go after visiting there and they have been left in the dust. They have so much to teach us. I have learned the alphabet and some keys words, and even been given a sign name. They basically all gather around you and give you a name based on a physical feature. You have to let go of your ego and insecurities for sure and remember that there is no ill intention, they are simply observing the obvious! I'll show you all my new name when I get home;)

The reality check has been working with the Social Work Group at the library. We meet 3 times a week with a group of students whose purpose is to support members of the community and each other. I am so impressed with the students genuine interest in helping those less fortunate, when they themselves face many, many challenges. We have three major focuses; education, community visits, and income generating activities. On my first day I basically visited all the classes and introduced myself and what I hope to accomplish with them. I let them know that I would always be available if they want to talk or just get to know me and me them. The next day I had three students come to me throughout the day and open up about their struggle to pay their school fees. As much as I was grateful they felt comfortable coming to talk to me, I felt helpless in trying to work with them to find solutions. It is very difficult to imagine how these students feel when at home education is free and most of us take that for granted. These students are constantly reminded that education is the most important thing, and they must go to school in order to have a successful future. To be told that your entire life and then to lose both parents, be living with an elderly grandparent who needs to be cared for, and make just enough money to pay for rent and food for the family, only to be sent home from school unless you come back with a substantial amount of money is devastating for these young people. This is why I am trying to work with the social work group to develop some skills that we can use to generate funds. Tomorrow we are working on paper beads, and we will hopefully have a visitor next week coming to teach us basket weaving using banana fiber. I feel hopeful, and I know the students are interested, I just wish I had more time to really get the program on its feet. We have already missed two out of our three weekly meetings because more than half the school had been sent home until they brought back some money. I am even thinking long term and how I could set up a Social Work Group Scholarship Fund from home. I know I could do a fundraiser every few months and make enough money to support a large group of students pay for their fees for the year. I struggle with this idea for many reasons. One is thinking of the principles of the Uganda Project. Sustainability. Is something like a scholarship fund sustainable? How long will I continue to dedicate myself to the scholarship program? Another challenge for me is thinking about the international charity that swoops in and helps. The people here in Uganda are intelligent, resourceful, and capable people, and I struggle justifying to myself if bringing in international funding may in someway hinder the country's progression. These questions have no definite answer, and I hope I will get some clarity as my time here comes to and end.

Now that I have essentially written an essay, I have to say once again, that I am so grateful for this opportunity. I sometimes wonder what I could possibly be bringing to people here, when I am getting so much from them. Knowledge, passion, dedication, comfort, and friendship are some of the gifts I have been given, I only hope I can give them a fraction of the lifelong experience they have given me.

Less than one week left. I would like to think that time has gone by fast but looking back on my daily routines at Kitovu Hospital and weekends exploring Uganda I have had time to see and learn so much. We have three weeks left and although that does make me sad I am eager to take what I have been given here and apply it to my life and work back at home.

With it's organization and professional staff Kitovu has opened my eyes to how innovative and progressive Uganda is. The hospital it self is about 15 minutes out of Masaka's main street and the windy road leading up to it is nothing but green trees and flowers. The area it self is on a large hill that over looks a near by village clearly, in the distance you can also see Lake Nabugabu (which is connected to Lake Victoria). It's called Walungi (beautiful) Quarters and located on the far end of the hospital property. The hospital it self was built by Archbishop Joseph Kiwanuku in 1955 along with missionaries of Mary from Ireland, at that time everything at the hospital was free. Since then the hospital has been passed down to Ugandan missionaries. The hospital is also now private due to the lack in funding from Ireland. One of the missionaries in particular, Dr. Maura, has done significant amount of work on the grounds, after 50 years she continues to create changes. She has recently opened up a VVF (Vesicovaginal fistula) ward. This ward is open free of charge for all patients during a camp that is held three times a year. The recent camp ended at the beginning of this month and the amount of women here were flooding the grounds as they used the outdoor washing stations for their clothing and camped out in large black tent behind the ward. It's pretty amazing to see how much Dr. Maura has dedicated towards Kitovu. I had the privilege of meeting her this past Friday (Before this time I had seen her once at mass in the hospital cathedral). She called the social workers office and requested for a chart of a patient to be immediately delivered to her in the out patient department. This office is where I've spent most of my time with the senior social worker George and another social worker Miriam. During our brief phone call Dr. Maura told me that I sounded “very efficient” and asked who I was when she requested the chart. After hanging up I ran over to the records room. I told Specy (the record keeper) that this was an emergency she was laughing at how nervous I was. Her and I got started on sifting through stacks of paper that the hadn’t been filed yet. At this moment I was thinking wow after wasting time going through all this paper work Dr. Maura will be thinking “I guess this Amanjot from Canada isn't so efficient”. What felt like forever after about 5 minutes we found the chart and I bolted over to deliver it. She was very happy and greeted me with a genuine smile and curiosity about why I was here and what my name was. It was nice to see how humble and welcoming she was to me.

One thing I have noticed about the staff here are that they are very happy to be working in such a great place, they get treated well and I haven’t seen any signs of burn out. Everyone truly works as a team. The hospital it self is organized in a such a way that makes it easy for patients to receive various types of treatment. They have three theaters (operation rooms), a large maternity ward, surgical ward, x-ray, ultrasound, a children ward that is connected to a nutrition ward. In this ward malnourished children with their mothers can stay at the hospital learn how to cook and take care of their children properly until the child is treated. As social workers our team is frequently visiting this ward to visit mothers who may be abandoned by their husbands or cannot afford their bill upon discharge. The hospital also has a large laboratory and a regional blood bank that delivers blood to surrounding clinics and hospitals. I recently donated blood there which goes into a 450ml bag used for one adult or can be separated into three bags for children. The laboratory delivers immediate results for patients for example if the doctor needs a stool sample you simply head over to the laboratory, they give you instructions and deliver your results while you wait outside. You then head back to the doctor and they assess you with medication etc. Compared to Canada I think this is a pretty great system how all services are connected and work together. At any time if anyone has a social issue with money, burial services, transportation, HIV counselling or food the patients are sent over to the social workers office. This is where I have been meeting patients, building rapport through George's great translation as he allows me to engage in conversation as they sit close to me and I also use eye contact and gestures because although they cannot understand me I try my best to use non verbal ways of communication as George is translating my English to Ugandan.

Being here I have really kept in mind the idea of doing no harm I have stepped aside and tried to learn as much as I can, especially from George and Miriam. I have tried not to be responsible for directly delivering services and instead been a learner who supports the great staff members. It's hard to explain in words how challenges at the hospital affect my daily feelings and more recently I have often wondered how important the concept of doing no harm is. I can't help but think that my time here is and was for the most part learning, sitting back and taking in the way Ugandans handle situations. For example in the social work office, various patients and watching the way children are raised. If there was one thing I could I guess “contribute” to the people I have seen would be the gift and opportunity of education so that women especially, for me the ones in the nutrition and VVF wards can feel empowered and gain skills in confidence that can help them in child rearing and their own personal growth.

Uganda has captured my heart!

I don’t know where to start?  Uganda has captured my heart. Masaka is my home. I have this feeling here like I have been here before, like this is my home and I have come back. I know I sound sappy and cheesy but it is really the only way I can describe my time here this far.

I enjoy the food, the people and the weather. I feel accepted and like my practicum is the place for me to be. I have learned so much about myself in these past few weeks. The technical things are good to learn. Like mental health here and how people view it. The medications used… however it is the non-technical stuff like going into the community and peoples home then eventually their hearts is what has moved and changed me.

I came with the intention of learning about the traditional ways of the Ugandan people. I have since met many traditional healers and birth attendants that have been open to sharing their work and culture. This is the most amazing experience I could not have even imagined it to be. I feel a strong connection to what they believe and our traditional beliefs and practices at home with my people.

I didn’t use the word blessed until recently because I honestly feel blessed. I feel touched and honoured to have this time here sharing, learning and growing. I look forward to the weeks that come and I also feel a little sense of dread to go home and leave a piece of my heart here.

I have experienced music, dancing, food, language, art and culture. I am open to new experiences as they come. I have gotten my hair braided and the people here have really taken to it. I have taken it out after the month is over but I miss the braids already and know I will do it again before we leave. I have gotten a traditional dress called a Gomez made for me and I will be wearing it to an introduction that I have been invited to on our last day here. I think such an experience on my last day is really a fantastic way to say goodbye.